Belongingness, Work Engagement, Stress and Job Satisfaction in a Healthcare Setting

Megan Josling

Submitted in partial fulfilment of the requirements of the BA (Hons) in Psychology at

Dublin Business School, School of Arts, Dublin.

Supervisor: Dr. John Hyland

Programme Leader: Dr R. Reid

March 2015

Department of Psychology

Dublin Business School

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Contents

Acknowledgements........................................................................................................3

Abstract..........................................................................................................................4

Introduction....................................................................................................................5

Methodology.................................................................................................................17

Results...........................................................................................................................23

Discussion.....................................................................................................................34

References.....................................................................................................................43

Appendix.......................................................................................................................52

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Acknowledgements

I would like to express my gratitude to my supervisor Dr. John Hyland for his

inspiration, continual support and guidance throughout the duration of this study. In addition

I would like to extend my gratitude to Margaret Walsh, Dr. Rosie Reid and Dr. Patricia

Frazer for their dedication and support during our project classes.

This study would not have been possible without the TLC Healthcare Group who

granted me access to their employees to obtain my required sample. I would also like to

thank the employees who took the time out of their busy working days to participate in this

study.

Furthermore, I would like to thank my family and friends for their patience,

encouragement and continual support throughout this year.

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Abstract

Research has indicated that belonging, employee engagement and stress play an integral role

in perceived job satisfaction. Belonging, engagement and stress were explored as potential

predictors of job satisfaction in an Irish geriatric healthcare organisation. Seventy nine

nursing home employees completed four psychological measures including: Utrecht Work

Engagement Questionnaire; Psychological Sense of Organisational Membership

Questionnaire; Occupational Stress Index; Job Satisfaction Survey. Findings indicated that

belongingness, stress and work engagement are predictors of job satisfaction in an Irish

healthcare setting. Significant unique contribution was made by belonging and stress but not

engagement. There was no interaction effect between gender and belonging on job

satisfaction; no difference in scores on belongingness, stress, work engagement and job

satisfaction between healthcare and support staff; and lastly, no relationship between

employee length of service and job satisfaction. Findings highlight the important role of

stress, belonging and, to an extent engagement, in relation to job satisfaction.

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Introduction

The 2011 Irish Census indicated that over 56,000 nurses and 42,000 care assistants

were employed in both public and private healthcare sectors (Department of Health, 2012).

General support staff in the healthcare sector included about 10,000 workers, with total

healthcare professionals being estimated at around 104,000 individuals (Central Statistics

Office, 2012). With the healthcare industry playing an integral role in society, it is important

that those employed in the sector are physically and psychologically supported by both the

government and their respective employers. The HSE (2013, para.1) reports to provide

healthcare staff with occupational health support networks and aims to promote the wellbeing

of those in their employment. The Health Information and Quality Authority (HIQA) are the

inspecting and governing body for the provision of ethical and humane service in the Irish

healthcare sector. HIQA aims to ensure healthcare providers and employees adhere to

national healthcare and social care practices. With the expectation of optimal levels of care

from healthcare staff, it is important that their own physical and emotional wellbeing are seen

to as best as possible in order to provide such a service.

Job satisfaction has been shown to have a relationship with both psychological

wellbeing (Ramirez, Graham, Richards, Gregory, & Cull, 1996; Piko, 2006; Wright, &

Bonett, 2007) and physical wellbeing (Dua, 1994; Hoogendoorn, Bongers, De Vet, Ariens,

Van Mechelen, & Bouter, 2002). A meta-analytic study by Faragher, Cass, & Cooper, (2005)

indicated that job satisfaction has significant implications for psychological well being and

relates to levels of employee burnout, depression and anxiety. With this in mind it was an aim

of this study to investigate whether belongingness, stress and work engagement are predictors

of job satisfaction in the care of the elderly sector of the healthcare environment in Ireland.

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The importance of job satisfaction being the implications it has with regard to employee

psychological health and wellbeing.

Job Satisfaction

Job Satisfaction is considered to be the attitudes, whether positive or negative, a

person holds with regard to their current employment (Ajayi, & Abimbola, 2013). Sousa-

Poza & Sousa-Poza (2000) highlight that there are two potential ways of looking at job

satisfaction. From a bottom-up perspective, the work environment of the employee and the

degree to which their psychological and physiological needs are met influences their levels of

satisfaction. Alternatively from a top-down perspective, the intrinsic motivation and

disposition of the individual plays a key role in determining their level of satisfaction. A

bottom-up perspective is utilised for this study as the primary aim is to ascertain whether

stress, belonging and engagement are predictors of job satisfaction. Stress, belonging and

engagement levels being influenced by the psychosocial workplace environment the

employee finds themselves in.

Workplace satisfaction has major implications with regards to staff turnover,

absenteeism, burnout and productive performance (Singh & Dubey, 2011), as well as

individual wellbeing (Faragher, Cass, & Cooper, 2005). While this study aims to investigate

whether belongingness, employee engagement and perceived occupational stress are

predictors of job satisfaction in a healthcare setting, it is important to briefly discuss the

relationship between job satisfaction and employee work related behaviour, mainly that of

staff turnover, subjective burnout and employee absenteeism.

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Job satisfaction and burnout.

Job satisfaction has been statistically shown to be predicative of burnout (Kalliath, &

Morris, 2002), with a study by Piko (2006) on Hungarian care staff indicating that job

dissatisfaction was significantly linked to burnout, especially emotional exhaustion which in

turn was related to employee health. Burnout is defined as emotional exhaustion (depletion of

psychological and emotional energy reserves), negative attitude and affect of one’s work and

clients, and lastly a negative self-evaluation tendency (Maslach, & Jackson, 1981). Thus,

burnout does not just concern the individual employee and their well being but can also have

major implications for the healthcare workplace as a whole. Burnout has been described as

being the antithesis of engagement in existing literature (e.g. Leiter & Maslach, 2005;

González-Romá, Schaufeli, Bakker & Lloret, 2006; Schaufeli & Bakker, 2003), and adds

strength to the rationale of including engagement as a principle potential predictor of job

satisfaction in the present study.

Job satisfaction and absenteeism.

Absenteeism is defined as, “unscheduled disruption of the work process due to days

lost as a result of sickness or any other cause not excused through statutory entitlements or

company approval” (IBEC, 2011, p.8). Absenteeism does not only have implications for the

economy but it also places extra pressure (i.e. stress) on employees who have to compensate

for the absence of their colleagues. Cohen & Golan (2007) found that absenteeism was

strongly predicted by job satisfaction in an employee sample from long term healthcare

facilities. Thus it is suggested that in order to decrease absenteeism, healthcare organisations

need to focus on establishing what the predictors of job satisfaction are and implementing a

strategy to foster a highly satisfied environment for their employees to benefit the healthcare

industry, clients and the employees themselves.

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Hendrix, Gibson & Spencer (1994) found that there are gender differences in stress,

exhaustion, depression and absenteeism scores. They found that in females, the rate of

absenteeism due to wellbeing factors placed them under increased strain and stress to catch

up with their designated work once they returned. These findings provide evidence that stress

can lead to absenteeism and, to a degree, absenteeism can lead to stress. Perceived

occupational stress is included in this study as a target variable as there appears to be a stress-

satisfaction-absenteeism relationship (I.e. that stress is an antecedent of job satisfaction which

may lead to absenteeism, while stress appears to also have a direct relationship with

absenteeism).

According to Kass, Vodanovich & Callender (2001) length of service appears to be

correlated with both satisfaction and absenteeism in the workplace. A possible explanation

for this relationship could be that that the longer an individual is in a given position, the more

habituated they become to their working routine leading to a decrease in stimulation which

may influence their level of satisfaction and in turn rate of voluntary absenteeism. The

present study will thus also investigate whether there is a relationship between length of

service and job satisfaction in a sample of Irish healthcare/support workers.

Job satisfaction and turnover.

Although a certain level of staff turnover is beneficial for a company with an

introduction of new skills, ideas and different perspectives, a high level can have negative

effects in the workplace (Riggio, 2013). Nurse’s and healthcare assistants (HCA’s)

intentions to leave are significantly related to their levels of job satisfaction (Ramoo,

Abdullah, & Piaw 2013). Cohen-Mansfield (1997) report that aiming to reduce high levels of

turnover in Care Facilities is especially important, not just for the organisation but also for the

quality of care of the residents. This centres mostly on the idea that a high level of turnover

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can increase patient disorientation with the continual introduction of new staff as well as the

severing of the psychosocial bonds that they have established with their initial caregivers.

This suggests that not only is it important for the employee to be satisfied with their

workplace but that their satisfaction and intended turnover can have implications for those in

care, as well as for their colleagues (Vahey, Aiken, Sloane, Clarke & Vargas, 2004; O’Brien-

Pallas, et al, 2006; Mesirow, Klopp & Olson, 1998).

Personally identifying with an organisation can contribute to some degree to overall

individual satisfaction and influence turnover intention (Van Dick et al, 2004).

Belongingness and engagement are central variables in this study as it has been suggested

that creating a psychosocial workplace environment that encourages a sense of belonging and

identification can foster an increase in job satisfaction and thus decrease intended staff

turnover. Identification is suggested to encompass the tendency for individuals to conform to

organisational norms as well as integration with individual self concept. It could be argued

that this identification could be viewed as a facet of work engagement.

Thus far it has been established that the study of job satisfaction is important due to its

relationship with employee wellbeing, employee burnout, absenteeism and staff turnover. It is

now important to look at the possible predictors of job satisfaction. In an Irish study, Curtis

(2007) found low to moderate of job satisfaction levels in a nursing sample with variables

such as professional status, interaction and autonomy significantly relating to increases in job

satisfaction while task requirements, policies and remuneration did not. More general

findings have suggested that job satisfaction is significantly related to perceived stress

(Zangaro & Soeken 2007), co-workers, promotional opportunities, superiors, and

compensation (Nicholas, Howard & Jules, 2006).

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Taking these factors into account, this study aims to look at employee engagement,

stress and belongingness as predictors of job satisfaction in both healthcare and support staff

in a long term Nursing Home facility in Ireland. These variables were selected as they have

been significantly linked with job satisfaction in past research.

Employee Engagement

Kahn (1992) highlighted that if a person is psychologically present, i.e. that they are

attentive, connected, integrated and focussed in the workplace, then they are able to perform

their job role at an optimal level as well as directing own personal skill and competency

growth. The idea of employee immersion in their work has lead to a large body of research

over the last decade in the direction of employee engagement (e.g. Moura, Orgambidez-

Ramos & Goncalves, 2014; Macey & Schneider, 2008; Alarcon & Lyons, 2011; Saks, 2006;

Torrente, Salanova & Llorens, 2013; Schaufeli, Bakker & Salanova, 2006; Bakker, Schaufeli,

Leiter & Taris, 2008).

Employee engagement can be defined as workplace motivation characterised by

vigour, dedication and absorption (Moura, Orgambidez-Ramos & Goncalves, 2014). Macey

& Schneider (2008) propose that engagement can either be a psychological state i.e. positive

affect, high job enthusiasm and involvement, integration of organisational identity with

individual identity, pride in the workplace; or behavioural actions of engagement including:

organisational citizenship behaviours, pro-activity in the workplace as well as showing

initiative and dedication to tasks and objectives. Their critical evaluation of engagement

research and measurement did indicate that there is still a gap in the literature regarding a

unitary view of what engagement constitutes. There was also concern with regard to the

established measures of engagement, with a query existing whether or not the measures are

reliable and valid. They do however indicate that two measures are excluded from this

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concern, including the Utrecht Work Engagement Scale (Schaufeli, Salanova, González-

Romá, & Bakker, 2002; Schaufeli & Bakker, 2003) which was utilised in this study.

Although questions exist regarding engagement as a distinct construct, argument has

been made that work engagement was shown to be a distinct and separate from both job

involvement and organisational commitment by Hallberg & Schaufeli (2006). Although all

three constructs are associated with positive attitudes and affect experienced towards the

workplace, job involvement is characterised by preoccupation and concern for the job

(Kanungo, 1982) and organisational commitment pertaining to identification and integration

of the organisational goals and values, a motivation to remain with the organisation and a

willingness to exert effort to ensure the success of the organisation (Steers, 1977). With a

study by Scrima, Lorito, Parry & Falgares (2014) providing evidence of the separateness of

the constructs in that work engagement mediates job involvement and organisational

commitment.

Further studies have examined the direct and indirect relationship between work

engagement and job satisfaction (e.g. Giallonardo, Wong & Iwasiw, 2010; Alarcon &

Edwards, 2011; Saks, 2006). In addition, a cross sectional study by Moura, Orgambidez-

Ramos & Goncalves (2014) found that role conflict and work engagement significantly

predicted job satisfaction. More specifically they found that stress and engagement were

negatively correlated. This suggests that when unrealistic demands are expected from an

employee, there is a chance they may experience a decrease in engagement with a domino

effect likely to occur on the positive relationship between engagement and satisfaction. They

further suggest that this mediating role comes from the depletion of physical and

psychological reserves when faced with excessive stressors leading to a decrease in

absorption and dedication. As this study implies there is a stress-engagement-satisfaction

relationship, stress was thus included as a central variable in this study.

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Occupational Stress

Singh & Dubey (2011) define stress as ‘a physiological and psychological reaction to

relatively excess demands made on a person’ (p.43). In their study they propose that job

satisfaction is a useful outcome measure of stress in the workplace as it can be linked to

negative affect induced by stressors employees may encounter. Their research adds to the

above mentioned stress-engagement-satisfaction relationship by providing evidence that

stress can also have an effect on performance (i.e. stress-engagement-satisfaction-

performance relationship).

In a study with a sample of nursing professionals, Happell, Dwyer, Reid-Searl, Burke,

Caperchione & Gaskin (2013) identified that potential stressors included high workloads,

unavailability of doctors, unsupportive management, human resource issues, interpersonal

issues, patients’ relatives, shift work, handover procedures, no common area for nurses, not

progressing at work and patient mental health. These findings are similar to that of Lapane &

Hughes (2007), whose study also identified the main source of stress for HCA’s include poor

pay, understaffing, and excessive workload. No research has identified the main sources of

stress for nursing home support staff as of yet.

Work related stress research is important as perceived stress has implications not just

for the individual and their well being but also for those in their care and the organisation as a

whole. Findings by VonDras, Flittner, Malcore & Pouliot (2009) indicate that perceived

psychological stress has a significant negative relationship with job satisfaction and the

experience of stress affected decision making on ethical issues such a taking short cuts in

patient care to complete all work related tasks. They also found if the service was made

available, there was significant interest in training on how to cope with stress. As frustration,

stress and being overwhelmed are the main source of ‘care short-cuts’ it is important for

healthcare organisations to provide coping training and supervisor support (McGilton, Hall,

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Wodchis & Petroz, 2007) for their staff to ensure optimal levels of satisfaction and wellbeing

so that they can provide the best care that’s within their power to provide (VonDras, Flittner,

Malcore & Pouliot, 2009).

Research has indicated that an effort-reward imbalance (ERI) can lead to job

dissatisfaction and increased turnover intentions (Dill, Morgan, & Marshall, 2013), with

dissatisfaction also being linked to employee burnout (Piko, 2006). Van Vegchel, De Jonge,

Meijer & Hamers (2001) reports significant findings that ERI in a healthcare setting can have

negative effects on both the physical and psychological wellbeing of employees. While in a

nursing sample Bakker, Killmer, Siegrist & Schaufeli (2000) found that nurses who exerted

high effort to meet organisational goals of exemplary care, but received low levels of

rewards, had higher burnout scores (especially exhaustion and depersonalisation). From this

research of ERI and previously mentioned stress research it can be argued that in order to

maintain the wellbeing and satisfaction of employees, which has further effects at patient and

organisational levels, healthcare employers have a responsibility to establish an equitable

effort-reward system as well as providing support systems for those in their employment.

A trend in occupational stress management research has been focused on individual

interventions of stress management. However, in a review study by Giga, Noblet, Faragher &

Cooper (2003) they found that the most effective means of reducing stress in the workplace is

via an organisational level of intervention. This suggests that although looking after

individual employee wellbeing is dramatically important for an organisation, group level

stress management tends to be more beneficial in the long run. It may be that when

interventions are performed at group level, it fosters a sense of social support. Social support

being and important factor influencing work related outcomes.

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Belongingness

In general, a sense of social support has been shown to have a significant correlation

with work related outcomes including: burnout, job satisfaction and employee performance

(Baruch-Feldman, Brondolo, Ben-Dayan, & Schwartz, 2002). Similar findings were reported

by Mark & Smith (2012), where high satisfaction in the workplace was related to social

support, job control and personal factors such as coping strategies and attribution styles in a

university employee sample. It could be argued a sense of belonging can be fostered through

support from peers and supervisors.

Baumeister & Leary (1995) reviewed belonging literature and came to the conclusion

that belonging is a strong innate desire to connect with others. Their review suggests that

people make social bonds with very limited encouragement (influenced by proximity and

similarity) with quality rather than quantity being important when it comes to relatedness and

belonging. It should be noted that belonging plays a role in human emotion, wellbeing and

cognition (effects of thinking about interpersonal relationships). They pose the theory that if

the belongingness hypothesis is correct, that a substantial amount of human behaviour will be

influenced by its motivational driving forces.

According to Cockshaw & Shochet (2010) workplace belongingness can be defined

as the extent to which a person feels included, supported and at one with their psychosocial

workplace environment. Their study indicates workplace belongingness is related to

emotional wellbeing (depression, anxiety, stress). It should be noted that depressive

symptoms can influence the level of belongingness an individual experiences, but on the

whole the suggestion stands that the workplace, as a social environment, plays a significant

part in the subjective wellbeing of employees. A relation between work engagement and

belonging can also be argued. For example, Van Dick et al, (2004) proposed that

organisational identification (tendency to conform to norms and integrating organisational

15

values with subjective self concept) is linked with job satisfaction and influences turnover

intention. Thus they suggest fostering identification and belonging in an organisation could

have positive effects on job satisfaction and decrease turnover intentions.

Social cohesion and friendship was identified by Maslow (1967, 1970, as cited by

Riggio, 2013) as a third level motivational force in his five stage hierarchy of needs theory.

Belonging is a part of social cohesion, as it pertains to the degree to which an individual feels

integrated into their psychosocial workplace environment and their work group. Concepts of

group functioning and group dynamics become significant in this respect. However, it is not

an aim of this study to determine how a group functions, but rather how the degree to which

individuals perceive themselves as belonging in their workplace environment is related to

their job satisfaction.

Support for a relationship between a sense of belonging and satisfaction has been

reported by Winter-Collins & McDaniel (2000) in a sample of graduate nurses. They found

that belonging was significantly related to total satisfaction, interaction opportunities and

their co-workers. It should be noted that they were least satisfied with opportunities for

individual and career advancement. This suggests, although social inclusion is important for

wellbeing, is not a unitary factor influencing satisfaction. It is thus of interest to this study to

identify whether belonging predicts job satisfaction in a sample of Nursing Home employees.

The Current Study

Job satisfaction is an important predictor of performance, turnover intention and

absenteeism, as well as employee health and wellbeing. For this reason it is important to

establish what the predictors of job satisfaction are in a long term care nursing home setting

where the main occupational function is to provide a service of care and support for those

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who are vulnerable or unable to care for themselves, while maintaining an occupationally

healthy and supportive environment for all staff.

Although most of the above mentioned findings mainly come from samples consisting

of nurses, this quantitative questionnaire study aims to fill a gap in the existing healthcare job

satisfaction research in an Irish setting by investigating whether belongingness, work

engagement and occupational stress predicted levels of job satisfaction in both healthcare and

support staff nursing home workers. These variables are included as previous research has

indicated that they play an important role in the development and maintenance of subjective

job satisfaction.

Hypothesis 1

It is predicted that belongingness, work engagement and occupational stress predict job

satisfaction.

Hypothesis 2

It is predicted that there is an interaction between belongingness and gender in job

satisfaction.

Hypothesis 3

It is predicted that belongingness, work engagement, job satisfaction and occupational stress

will differ depending on type of position a person holds within a company

Hypothesis 4

It is predicted that length of service in a company will be related to job satisfaction

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Methodology

Participants

The sample comprised of 79 employees from two separate care units of a private

nursing home healthcare organisation. The mean age of the sample was 33.41 years, ranging

from 19 to 61 years old (SD = 11.48). 18 male (21% of overall sample) and 61 female (79%

of overall sample) participants took part in the study. The participants were from both

healthcare (nurses, HCA’s, nursing management; N = 55) and support positions (catering,

housekeeping, HR, maintenance; N = 22) (2 of unknown positions). Length of service ranged

from 2.5 to 96 months (M = 25.58; SD = 20.43)

An opportunistic convenient sampling method was used (non-probabilistic sampling).

Thus, not all employees had equal opportunity to take part in the study i.e. those not on duty,

sick, on holidays or missed in the process.

Design

A quantitative correlational design was employed for this study. Key variables

included workplace belongingness, job stress, workplace engagement, job satisfaction, age,

gender, position in company and length of service. The variables altered in respect to being

either the IV/PV or DV/CV depending on the research question under investigation. The

design was cross sectional for Hypothesis 2 and 3 as comparison were made between

independent groups for both these hypotheses.

Hypothesis 1.

Predictor variables included workplace belongingness scores, work engagement scores and

occupational stress scores. The criterion variable was job satisfaction scores.

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Hypothesis 2.

Independent variables included sex and workplace belongingness scores with the dependent

variable being job satisfaction scores.

Hypothesis 3.

The independent variable was position type (nursing vs. non-nursing) and dependent

variables included workplace belongingness scores, work engagement scores, occupational

stress scores and job satisfaction scores. The overarching term for the four dependent

variables for the purpose of this hypothesis was ‘Subjective Workplace Evaluations’.

Hypothesis 4.

The predictor variable was length of service (months) while the criterion variable was job

satisfaction scores.

Materials

Demographic questionnaire.

Demographic questions pertained to sex, age, position type and length of service. For

the age and length of service questions participants were required to respond with figures,

producing scale level data. The age value was in years and although length of service was in

years and months, the researcher converted this to monthly values for later data analysis. Sex

and position type required participants to select one of two categories, male or female for sex

and either healthcare (nurses, HCA’s, nursing management) or support (household, catering,

HR, maintenance) for position type. These categories were used for intergroup comparisons

(H1 2 & H1 3)

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Utrecht work engagement questionnaire.

Utrecht Work Engagement Questionnaire (Schaufeli & Bakker, 2003) consists of 17

items measuring participants self reported level of work engagement. It has three subscales

including vigour (6 items e.g. ‘At my work, I feel bursting with energy’), absorption (5 items

e.g. ‘Time flies when I’m working’) and dedication (6 items e.g. ‘I find the work that I do full

of meaning and purpose’). Participants are required to indicate on a 7 point likert scale how

often each statement applies to them with 0 – ‘never’ through to 6 – ‘daily’. The possible

range of scores, if all questions are answered is between 0 and 102, with higher scores

indicating employee engagement.

As engagement is defined as being on the opposite spectrum of burnout; it could be

assumed that the closer a participant scores to 0 on this measure the more likely it is that they

may be experiencing burnout. Schaufeli & Bakker (2003) report a series of validity studies

which indicated a strong negative relationship between burnout and engagement. Stability

over time for this measure was reported at r1=.63/.72 across overall scoring in two samples.

Internal consistency of the measure is good with Chronbach alpha coefficient ranging

between .88 and .95.

Psychological sense of organisational membership scale.

Psychological Sense of Organisational Membership (PSOM) is Cockshaw & Sochet’s

(2010) adaptation of Psychological Sense of School Membership (PSSM) by Goodenow

(1993). The PSSM is an 18 item measure of belonging for adolescents in secondary

education. The reliability of this measure is good with an alpha score of .88. Participants are

required to indicate on a 5 point likert scale how true each statement is for them with 1 – ‘not

true at all’ through to 6 – ‘completely true’. The possible range of scores, if all questions are

answered is between 18 and 90, with higher scores indicating a sense of belonging. Reverse

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scoring is required for questions 3, 6, 9,12, and 16. Cockshaw & Sochet (2010) adapted this

measure by substituting work related concepts for school related ones e.g. ‘I feel like a real

part of this school’ vs. ‘I feel like a real part of this organisation’ or ‘Teachers at my school

respect me’ vs. ‘The managers/supervisors here respect me’. Internal consistency was

reported at .94 (Cockshaw, Shochet & Obst, 2014).

Occupational Stress Index (OSI).

The original OSI by Strivastava & Singh (1981) has 50 items. It has internal

consistency of .935 by split halves method and a Chronbach alpha coefficient of .90.

However, this study utilised a shortened 15 item version of the OSI adapted by Singh &

Dubey (2011) which has three subscales including work overload (α =.684) e.g. ‘I have to do

a lot of work in this job’, work ambiguity (α =.554) e.g. ‘The available information relating

to my job role and its outcomes are vague and insufficient’, and work related conflict (α

=.696) e.g. ‘My different managers often give contradictory instructions regarding my work ’.

Participants are required to indicate on a 5 point likert scale much they agreed with each

statement with 1 – ‘strongly disagree’ through to 6 – ‘strongly agree’. High scores on this

measure indicate high levels of perceived work related stress. The possible range of scores is

between 15 and 90. Negative scoring is required on items 5, 6 and 12.

Job Satisfaction Survey (JSS).

The JSS (Spector, 1994) consists of 36 items with nine subscales present in the

measure. Participants indicate on a 6 point likert scale how much each statement applies to

them with 1- ‘strongly disagree’ through to 6 – ‘strongly agree’. The possible range of scores

lies between 36 and 216. High scores on this measure indicate job satisfaction.

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Each of the 9 subscales consists of 4 items, the subscales include: Pay (α =.75) e.g. ‘I

feel I am being paid a fair amount for the work I do’, Promotion (α =.73) e.g. ‘There is really

too little chance for promotion on my job’, Supervision (α =.82) e.g. ‘My supervisor is quite

competent in doing his/her job’, Fringe Benefits (α =.73) e.g. ‘I am not satisfied with the

benefits I receive’, Contingent rewards (α =.76) e.g. ‘When I do a good job, I receive the

recognition for it that I should receive’, Operating conditions (α =.62) e.g. ‘Many of our rules

and procedures make doing a good job difficult’, Co-workers (α =.60) e.g. ‘I like the people I

work with’, Nature of work (α =.78) e.g. ‘I sometimes feel my job is meaningless’ and

Communication (α =.71) e.g. ‘Communications seem good within this organization’. Internal

consistency of the overall measure is α =.91. Negative scoring is required on items 2, 4, 6, 8,

10, 12, 14, 16, 18, 19, 21, 23, 24, 26, 29, 31, 32, 34, 36.

Procedure

After the organisations’ ethical committee had met and granted access to the sample,

the researcher administered the set of questionnaires (Appendix A-G) to each staff member

who voluntarily chose to participate. Employees were verbally asked to take part in a study of

the predictors of job satisfaction in a healthcare setting. In the cover letter (Appendix A) it

was indicated that the variables that were being measured included belongingness, stress,

employee engagement and job satisfaction. None of the actual measures, bar the demographic

questionnaire, had the titles provided. The titles of the measures were provided; along with a

description of each variable, on the participant debrief set (Appendix G).

As the study required the participation of employees who were involved in a regular

working day, the researcher gave out the questionnaire sets during the morning (11 a.m.) and

collected them later in the evening (4 p.m.). This was done to not place any pressure on the

participant to complete it straight away, while also allowing them to perform their normal

22

daily duties. Participants were given an envelope to put their completed questionnaire set into

after completion to ensure the maintenance of their privacy. This also allowed the participants

to hand in the questionnaire sets to reception if they chose which the researcher later

collected. Data was collected over a period of 7-14 non consecutive days.

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Results

Descriptive Statistics

Descriptive statistics of demographic data is represented in Table 1. Most of the

participants came from Nursing Home 1 (N = 59), were female (N = 61) and part of the

Healthcare team (N = 55) within the overall organisation. Mean age of the sample was 33.41

years (SD = 11.79) and mean length of service of the sample was 25.4 months (SD = 20.22).

Note, five participant’s data were excluded from further analysis as they failed to complete at

least 90% of the questions from the 90 item questionnaire set.

Table 1.

Demographics

Variable N % Mean Standard

Deviation

Minimum Maximum

Workplace

NH 1 59 74.7

NH 2 20 25.3

Gender

Male 18 22.8

Female 61 77.2

Job Type

Healthcare 55 69.6

Support 22 27.8

Age 76 33.41 11.79 19 61

Length of

service

75 25.40 20.22 2.50 96.00

The means, standard deviations, minimum and maximum as well as the internal

reliability scores for the four psychological measures (Belonging, Engagement, Stress and

Job Satisfaction) are displayed in Table 2.

24

Table 2. Descriptive Statistics of Psychological Measures Job Satisfaction, Belongingness, Employee Engagement and Occupational Stress

Variable N Minimum Maximum Mean SD α

Job

Satisfaction

79 71.00 196.00 134.57 23.65 .80

Belonging 79 30.00 90.00 69.41 12.76 .90

Engagement 79 31.00 101.00 73.68 14.72 .81

Stress 79 15.00 63.00 41.70 9.32 .78

Table 3 shows the inter-correlations, means and standard deviations of the nine Job

Satisfaction Scale subscales (Pay, Promotion, Supervision, Fringe Benefits, Contingent

rewards, Operating Conditions, Co-workers, Nature of Work and Communication). Figure 1

graphically represents the means reported by this sample across the nine subscales while

Figure 2 represents the current sample’s mean scores of the nine subscales against scores

reported by Spector (1994, 2011) of US and Non-Us samples. Noteworthy is the difference in

the current sample’s scores on pay, fringe benefits and communication against the

accumulated US and non-US data.

Total score for job satisfaction ranges between 36 and 216. Spector (1994, 2011)

logically but arbitrarily proposed scores between 36 - 108 suggest dissatisfaction, 108 - 144

suggests ambivalence and 144 - 216 suggest satisfaction. Overall job satisfaction mean

calculated for this sample was 134.57 (SD = 23.65) falling under ambivalence. When looking

at the job satisfaction subscales, scores can range between 4 and 24 with scores between 4 -

12 suggesting dissatisfaction, between 12 - 16 ambivalence and 16 - 24 suggesting

satisfaction. Taking this into account with regards to scores of this study; pay and fringe

benefit scores suggest dissatisfaction; promotion, contingent rewards and operating

conditions scores suggests ambivalence; supervision, co-workers, nature of work and

communication scores suggest satisfaction.

25

Note: N=79; *Correlations statistically significant (p<.05), **Correlations statistically significant (p<.001)

Table 3.

Job Satisfaction subscales inter-correlations and descriptive statistics

Pay Promotion Supervision

Fringe

Benefits

Contingent

Rewards

Operating

Conditions Co-workers

Nature of

Work Communication Mean

Std.

Deviation

Pay 10.25 4.72

Promotion .49** 12.39 4.09

Supervision 18.56 4.73

Fringe Benefits .49** .43** .26* 11.66 4.21

Contingent

Rewards .39** .34** .58** .39** 13.53 4.49

Operating

Conditions .32** .36** 14.29 3.35

Co-workers .54** .50** 18.22 3.53

Nature of Work .30** .29** .32** .38** .32** .41** 19.15 4.33

Communication .47** .36** .59** .36** 16.52 4.48

26

Figure 1. Bar Chart Graphically Representing Mean Scores on Job Satisfaction Subscales for the Current Sample.

Figure 2. Bar Chart Graphically Representing Mean Scores of Job Satisfaction Subscales of the Current Study against Accumulated US data and Non-US data retrieved from Spector (1994, 2011).

0 5 10 15 20 25

Pay

Promotion

Supervision

Fringe Benefits

Contingent Rewards

Operating Conditions

Co-workers

Nature of Work

Communication

Mean Scores

Job

Sat

isfa

ctio

n S

ub

scal

e

0

5

10

15

20

Me

an S

core

s

Job Satisfaction Subscales

This study

US

Non US

27

Table 4 shows the inter-correlations, means and standard deviations of the three

employee Utrecht Work Engagement Survey subscales (Vigour, Absorption and Dedication).

Total score for employee engagement ranges between 0 and 102. Taking scores between 0 -

34 to suggest disengagement, 34 - 68 suggesting intermediate engagement and 68 - 102

suggesting engagement, the sample appears to be high in engagement (M = 73.68, SD =

14.72). When looking at the employee engagement subscales, scores can range from 0 to 36

for vigour and dedication (0 - 12 as disengagement, 12 - 24 intermediate engagement, 24 - 36

high engagement) and 0 to 30 for absorption (0 - 10 as disengagement, 10 - 20 intermediate

engagement, 20 - 30 high engagement). Taking this into account with regards to scores of

this study all subscales suggests high engagement (vigour M = 25.16, SD = 5.72; dedication

M = 24.13, SD = 5.47; absorption M = 24.39, SD = 6.10).

Table 4.

Engagement Subscales’ Inter-Correlations and Descriptive Statistics

Vigour Dedication Absorption Mean

Std.

Deviation

Vigour 25.16 5.72

Dedication .62** 24.13 5.47

Absorption .61** .53** 24.39 6.10

Note: N= 79. **Correlation is significant at the 0.01 level

Table 5 shows the inter-correlations, means and standard deviations of the three

Occupational Stress Inventory subscales (Ambiguity, Conflict and Job Overload). Figure 3

graphically represents the means reported by this sample across the 3 subscales. Job overload

appears to attribute slightly more stress followed by workplace conflict and then work related

ambiguity. Total score for occupational stress ranges between 15 and 90. Taking scores

between 15 - 40 to suggest low stress, 40 - 65 suggesting moderate stress and 65 - 90

suggesting high stress, the sample appears to be under moderate stress (M = 41.70, SD =

9.32). When looking at the occupational stress subscales, scores can range from 5 to 25 with

28

scores between 5 - 11.67 suggesting low stress, between 11.67 - 18.34 moderate stress and

18.34 - 25 suggesting high stress. Taking this into account with regards to scores of this study

ambiguity (M = 10.90, SD = 3.76) is a low source of stress while conflict (M = 13.87, SD

=3.38) and job overload (M = 16.92, SD = 4.11) are moderate sources of stress.

Table 5.

Occupational Stress Subscales’ Inter-Correlations and Descriptive Statistics

Ambiguity Conflict Overload Mean

Std.

Deviation

Ambiguity 10.90 3.76

Conflict .61** 13.87 3.38

Overload .49** .50** 16.92 4.11 Note: N= 79. **Correlation is significant at the 0.01 level

Figure 3. Bar Chart Representing Occupational Stress Subscales for the Current Sample

Belongingness, as measured by the Psychological Sense of Organisational

Membership Scale, has a potential score range between 18 and 90. Taking scores between 18

- 42 to suggest low sense of belonging, 43 - 66 suggesting moderate sense of belonging and

66 - 90 suggesting high sense of belonging, the sample appears to experience a high sense of

belonging (M = 69.41, SD = 12.76). Note. Belonging scores violated two normal distribution

0

2

4

6

8

10

12

14

16

18

Ambiguity Conflict Overload

Me

ans

Sco

res

Occupational Stress Subscales

29

assumptions in the present study. However, it was decided that the statistical techniques

utilised in the analyses were robust enough to deal with this issue.

Inferential Statistics

Hypothesis 1.

A multiple regression was performed utilizing job satisfaction as the criterion variable

and belongingness, occupational stress and engagement as predictors in order to determine if

job satisfaction scores could be predicted as a function of workplace related belongingness,

stress and engagement scores. Note, two (belonging and stress) out of the three predictors

were loaded on the same dimension and thus the data violated collinearity diagnostic

assumption.

The results of the regression indicated that the three predictors explained 47% of the

variance (R2 = .47, F(3,75) = 23.66, p < .001). Thus, a combination of belongingness,

occupational stress and employee engagement significantly predicts job satisfaction. More

specifically, it was found that occupational stress (β = -.27, p = .005, 95% CI = -1.16 - -.22)

and belongingness (β = .46, p < .001, 95% CI = .48 – 1.23) made significant unique

contribution to the variance in job satisfaction while, although trending towards significance,

employee engagement did not (β = .15, p = .116, 95% CI = -.06 - .52). See Table 6.

Table 6. Summary of Multiple Linear Regression Analysis for Employee Job Satisfaction Scores (N=79)

Variable B SE(B) β t Sig. (p) sr2

Belonging .86 .19 .46 4.57 <.001 .15

Engagement .23 .15 .15 1.59 .116 .02

Stress -.69 .24 -.27 -2.93 .005 .06

Note. R2=.47

For every increase of 1 in belonging scores, it can predict a change in score of .86 in

job satisfaction, while every increase of 1 in stress scores it can predict a change in score of

30

-.69 in job satisfaction. The corresponding proportion of variance in job satisfaction scores

uniquely predictable from belongingness scores was obtained by squaring the value of the

part correlation of belonging with job satisfaction to yield sr2 belonging = .15 i.e.

belongingness uniquely explained 15% of the variance in job satisfaction scores. Stress

explained an additional 6% of variance within job satisfaction scores (sr2=.06).

Hypothesis 2.

A 2x2 between groups ANOVA was used to evaluate whether there is an interaction

between belongingness and gender in job satisfaction. Job satisfaction scores were subjected

to a 2 (male vs. female) x 2 (low belonging vs. high belonging) two-way analysis of variance.

Descriptive statistics are presented in Table 7.

Note, belongingness scores were scale level data which was converted to ordinal level

data via median split to produce two belongingness groups. Those falling below the median

(median = 72) were classified as the ‘low belongingness’ group and those falling above the

media were classified as the ‘high belongingness’ group.

Table 7. Descriptive Statistics of Job Satisfaction by Gender and Belongingness Groups

Belongingness Groups

Low Belonging High Belonging

Mean SD N Mean SD N

Gender

Male 123.00 25.78 12 140.50 25.67 6

Female 121.04 14.39 28 149.18 20.50 33

Summaries of the 2x2 ANOVA results are illustrated in Table 7. No significant

interaction effect was found with regard to the role of gender and belongingness on job

satisfaction (F(1,75) = .91, p =.344).

31

Table 7. ANOVA Summary for Job Satisfaction by Gender and Belongingness Groups

Source df MS F Sig. (p) 𝜼𝟐𝒑

Gender 1,75 142.79 .36 .550 .01

Belonging 1,75 6593.21 16.68 <.001 .18

GxB 1,75 358.65 .91 .344 .01

The main effect of gender indicated that neither men (M = 128.83, SD = 26.38) nor

women (M = 136.26, SD = 22.74) scored significantly different on job satisfaction, (F(1,75)

= .36, p < .550). However, the main effect of belongingness indicated that there was

statistically significant differences in job satisfaction scores between the low belongingness

group (M = 121.63 , SD = 18.21) and the high belongingness group (M = 147.85, SD =

21.23), (F(1,75) = 16.68, p < .001) with a small effect size (.18). See Figure 4.

Figure 4. Bar Chart Showing Differences in Job Satisfaction Scores between Low and High Belongingness groups

32

Hypothesis 3.

It was predicted that belongingness, work engagement, job satisfaction and

occupational stress will differ depending on type of position a person holds within a

company. Position type consisted of two independent groups namely healthcare and support

staff. A multivariate analysis of variance (MANOVA) was conducted on the dependent

variables of belongingness, work engagement, job satisfaction and occupational stress across

the healthcare and support staff groups. For the purpose of this study the overarching term

constituting belongingness, work engagement, job satisfaction and occupational stress is

‘subjective workplace evaluations’. Descriptive statistics for each of the dependent variables

according to the two independent groups are summarised in Table 8.

Table 8. Descriptive Statistics of Stress, Engagement, Belonging and Job Satisfaction Scores For Healthcare and Support Staff

Job type Mean Std. Deviation N

Stress

Healthcare

42.76

8.33

55 Support 38.32 10.80 22

Engagement

Healthcare

73.82

13.93

55 Support 71.82 16.42 22

Belonging Healthcare

68.64

12.22

55

Support 72.36 13.57 22

Job Satisfaction

Healthcare

133.96

22.53

55

Support 137.23 27.11 22

Findings indicate there was no statistically significant differences on subjective

workplace evaluations between healthcare and support staff (F(4,72) = 1.39, p = .247).

Univariate results demonstrated non-significant effects for all of the dependent variables

(Bonferroni adjustment of p t .0125). These results are summarized in Table 9.

33

Table 9. Between Subjects Effects on Stress, Engagement, Belonging and Job Satisfaction Scores for Healthcare and Support Staff

Hypothesis 4.

A Pearson’s correlation was conducted to explore whether length of service (in

months) (M = 25.4, SD = 20.22) within the healthcare organisation was related to job

satisfaction (M = 134.57, SD = 23.65). This analysis was found to be statistically

insignificant (r(73) = -.22, p = .064), indicating there is no statistically significant relationship

between length of service and job satisfaction scores.

Other findings.

Moura, Orgambidez-Ramos & Goncalves (2014) found that stress and engagement

were negatively correlated. The present study found a similar, although not statistically

significant, trend (r(79) = -.12, p = .298). This is also far less applicable for men (r(18) = .07,

p = .783) than women (r(61) = -.19, p = . 150) in the present study.

Source DV df MS F Sig.(p)

Job Type Stress 1,75 310.55 3.78 .056

Engagement 1,75 62.86 .29 .591

Belonging 1,75 218.31 1.37 .245

Job Satisfaction 1,75 167.38 .29 .590

34

Discussion

Aims

This quantitative questionnaire study aimed to fill a gap in the existing Irish

healthcare job satisfaction research by investigating whether belongingness, work

engagement and occupational stress predicted levels of job satisfaction within the private

geriatric healthcare sector. This study also attempted to address a limitation mentioned in

Cockshaw & Shochet’s (2010) study on whether or not there is an interaction effect between

gender and belongingness on a target variable, which in the present study was job

satisfaction. Further inquiry was made on whether or not scores on belongingness, work

engagement, stress and job satisfaction scales differ across different occupational roles

(healthcare vs. support staff) as well as whether there was a relationship between length of

service and job satisfaction.

Findings

Overall findings indicated that nursing home employees are generally ambivalent with

regard to job satisfaction. They are mostly satisfied with supervision, co-workers nature of

work, and communication, less so with promotion, contingent rewards and operating

conditions and dissatisfied with pay and fringe benefits.

Hypothesis 1.

Keeping in mind that belonging and stress were loaded on the same dimension and

violated collinearity checks in the regression analysis, it was found that together,

belongingness, engagement and perceived occupational stress significantly predict changes in

experienced job satisfaction. However, individual results showed that only belonging and

stress made significant unique contributions to job satisfaction. A positive change in

35

belonging scores predicted a significant positive change in satisfaction levels (i.e. towards

satisfaction) in nursing home employees. Whereas with regards to stress, an increase in stress

scores predicted a significant change in job satisfaction levels (i.e. towards dissatisfaction).

Employee engagement had no significant individual predictive effects on job satisfaction

scores in the current sample although it could be argued that results are trending towards

significance.

Belonging and social support had been identified as being significantly related to job

satisfaction in previously mentioned studies (Baruch-Feldman, Brondolo, Ben-Dayan, &

Schwartz, 2002; Mark & Smith, 2012; Winter-Collins & McDaniel, 2000). The present study

provides additional support for this in establishing that changes in belongingness significantly

predict changes in job satisfaction. Addressing these findings in light of Baumeister &

Leary’s (1995) belongingness hypothesis, it could be argued that the strong innate desire for

humans to connect with one another acts as a motivational driving force within the

workplace. Belongingness, as a contributing factor to experienced job satisfaction, highlights

the importance of social connection in a healthcare-workplace setting. This viewpoint is also

supported by Maslow’s (1967, 1970, as cited by Riggio, 2013) hierarchy of needs theory. As

his theory would suggest that the need to belong needs to be satisfied before an individual can

continue on to confidence and achievement in work related tasks.

Organisational stress research has established that there is a relationship between

perceived stress and job satisfaction (VonDras, Flittner, Malcore & Pouliot, 2009; Singh &

Dubey, 2011; Bakker, Killmer, Siegrist & Schaufeli, 2000). The present study adds support to

this previous research. Effort-reward imbalance can be used to explain why increases in stress

predict a decrease in job satisfaction as found in this study (Bakker, Killmer, Siegrist &

Schaufeli, 2000). It can be argued that when a staff member is faced with significant stress,

without equitable rewards (as indicated by this study there was high to moderate

36

dissatisfaction with regard to level of pay and fringe benefits as well as promotion, contingent

rewards and operating conditions), their general job related satisfaction decreases.

The lack of significant predictive results between engagement and job satisfaction,

while controlling for belonging and stress, was unusual as previous research has highlighted a

significant relationship between the two constructs (Giallonardo, Wong & Iwasiw, 2010;

Alarcon & Edwards, 2011; Saks, 2006). More specifically, in Moura, Orgambidez-Ramos &

Goncalves’s (2014) study, a predictive relationship was suggested between work engagement

and job satisfaction, however, findings from the present study does not support this.

It is unclear why engagement did not have any unique contribution in the regression

model. A tentative reason for the lack of significance in this study could be that job

satisfaction can be conceptualised as a component of engagement (Riggio, 2013). If this is the

case, then the argument can be made that engagement goes beyond job satisfaction. This view

is supported Christian, Garza, & Slaughter (2011) who proposed that as a construct

engagement relates more to the level of work related activation rather than the attitudinal

feeling of satisfaction by the work. Thus, job satisfaction is an attitude description relating to

the characteristics of a job while engagement is descriptive of experiences consequential of

the work i.e. the states of vigour, absorption, and dedication.

Hypothesis 2.

There was no interaction effect between gender and belonging on scores of job

satisfaction, although it was found that there was statistically significant difference between

the low and high belongingness groups on job satisfaction scores. In other words,

belongingness’ effect on job satisfaction does not depend on gender. Although these findings

do not stand alone and provide support for the second hypothesis, it does add additional

support to the first hypothesis. When considering both the findings of the regression and the

37

ANOVA analysis it can be said that an increase in belonging leads to an increase in job

satisfaction and this is supported by the further findings that the low belonging group had

lower job satisfaction scores compared to the higher belonging group. This hypothesis

developed out of a limitation from Cockshaw & Shochet’s (2010) work. However, their

question for future research was whether an interaction effect exists between gender and

belonging on wellbeing. The transformation of this research question to relate to job

satisfaction thus does not answer their proposed research question and thus still stands as a

researchable hypothesis.

Hypothesis 3.

It was found that belongingness, work engagement, occupational stress and job

satisfaction did not differ between the healthcare and support staff groups. This suggests that

although the occupational roles of the different groups are different in terms of their job roles

and responsibilities, that perceptions, experiences and attitudinal evaluations of their

psychosocial workplace experiences are similar. No comparison studies between healthcare

and support workers have been conducted prior to this research on belonging, engagement,

perceived stress and job satisfaction. The fact that these two work groups do not differ

significantly on the target variables suggests that organisational research regarding the

antecedents of job satisfaction in the healthcare setting may be generalised to all occupational

groups. Further research using alternative target predictor variables, as well as a replication of

the current studies’ findings, is suggested to provide further support for this implication.

Hypothesis 4.

Lastly, length of service was not significantly related to job satisfaction. These

findings are inconsistent with that of Kass, Vodanovich & Callender (2001) who found that

38

there was a significant correlation between length of service and job satisfaction. However, it

should be noted that their study did include boredom as a moderating variable for this

relationship. In light of their researcher, the present findings suggest that habituation as a

result of length of service does not relate to job satisfaction in nursing home staff. A possible

reason for this, in light of Kass, Vodanovich & Callender’s (2001) work, could be that as it is

a service centred on care of individuals who have diagnoses of age related neurocognitive

disorders and general age related decline, that the day to day working routine of most staff

may be notably variable. However, boredom was not measured in the present study and thus

this is a guarded explanation. Also, the average reported length of service was relatively low

(just over 2 years) and job related boredom may not yet be present. Further investigation is

required to establish if this explanation is viable.

Potential Weaknesses of the Study

As this study utilised a quantitative questionnaire based design it is impossible to

determine a cause-effect relationship between the target variables. Also, the study was based

on self report data and thus participants may have intentionally or unintentionally failed to

report their true feelings. One issue that was raised to the researcher was that the language

used in the scales was difficult to understand, especially in the case of the Spector’s (1994)

Job Satisfaction Survey. Future research in the area with a similar sample would benefit from

utilising a different instrument. Alternatives include the Minnesota Satisfaction Questionnaire

(MSQ) by Weiss, Dawis, & England (1967) which comes in two forms (100 item and 20 item

versions) and assesses global satisfaction (intrinsic and extrinsic sources) with 20 subscales

Alternatively the Job Descriptive Index (JDI) developed by Smith, Kendall, and Hulin (1969)

which has been popular with researchers due to its brevity compared to the MSQ and is

comprised of Five facets (Work, Pay, Promotion Opportunities, Supervision, Co-workers).

39

The JDI has undergone three updates, the most recent being from 2008 (Bowling, Hendricks

& Wagner, 2008) and thus has merit as a rigorous and up to date measure.

Furthermore, there was a low level of control over participants completing the

questionnaire on an individual level. As the questionnaire sets were left with participants to

complete over the course of their working day and collected at a later allocated time, it is not

possible to assume that a collaborative attempt was not made by participants. The downside

of this being that social desirability and group think may have altered the responses that were

provided.

A final limitation of this study is that it’s based on a small sample size. Only 84

participants returned their questionnaire sets out of the possible 200 that were handed out.

Out of the 84 only 79 participants’ data was used as 5 participants failed to complete 90% of

the questionnaire sets and thus were disqualified from the study as their responses would

have lead to a decrease in the reliability of the measures. In order to increase the

generalisability of these findings it is suggested that future research obtain a larger sample

size and include more than one healthcare organisation from both private and public sectors.

Strengths of the Study

Although the above mentioned limitations exist with regard to the present study, it

also has significant strengths. This study added to existing knowledge of the predictors of job

satisfaction. Results indicated that perceived stress, a sense of belongingness and engagement

predicts job satisfaction, with unique contribution by both belongingness and stress in nursing

home healthcare and support workers. The inclusion of support staff as a target population

provided a more comprehensive account of the proposed antecedents of job satisfaction, and

thus provides some support for generalising across a nursing home staff population than

focussing solely on either nurses or HCA’s.

40

It was expected that female participants will make up the majority of the sample as

it’s historically a female dominated field. The Central Statistics Office (2011) reported

findings that only 1 in 6 men occupy a job in caring, leisure or other services. Even though

men were underrepresented in this study if viewed from a general country wide perspective,

it could be argued that they are representative of the subset of men working in the healthcare

and support worker field. In short, more men completed the study than had initially been

anticipated.

Future Research

The findings from the present study suggest persons employed in nursing homes are

under a moderate level of stress. There were no statistically significant differences between

healthcare and support staff scores on perceived stress, highlighting that support staff are

under similar stress as their healthcare counterparts. Support staff are significantly

underrepresented in current research. Their roles are as important as healthcare staff in the

running of any nursing home or healthcare facility. Thus it would be beneficial for future

research to identify the stressors of both healthcare and support staff in order to bridge this

gap in healthcare organisational research. Comparison of main stressors will give greater

insight into potential problem areas that can be addressed to produce an optimal working

environment.

Future enquiry will also benefit from investigating the intrapersonal characteristics

and dispositional styles (top-down perspective) contributing to experienced job satisfaction of

those in nursing home employment. With this in mind, future research should intend to add to

existing literature by establishing a link between the stress-belonging-satisfaction predictive

model identified in this study, as well as any other intrapersonal and dispositional

41

characteristics that may be identified in further research, with work related outcomes such as

absenteeism, turnover and burnout.

There may be merit in using an alternative measure in future studies along the line of

the current research e.g. the Q12 instrument. The Q12 is a standardised composite measure

by Gallup Inc. (Harter, Schmidt, Killham, & Agrawal, 2009) (Cronbach’s alpha of 0.91)

which measures issues managers can act upon to influence attitudinal outcomes such as

satisfaction, loyalty, pride and intent to stay with the company. It comprises of an initial

general satisfaction item and 12 other items explaining why people are satisfied and why

employees become engaged in their workplace. Within the 12 items there are also questions

relating to belongingness (e.g. ‘I have a best friend at work’; ‘My supervisor, or someone at

work, seems to care about me as a person’) which can influence communication and trust.

This instrument covers three of the core variables of the present study, namely job

satisfaction, belonging and engagement.

Implications

In general, the results of this study implies that healthcare organisations will benefit

from fostering a sense of belonging within their workforce while concurrently attempting to

identify and reduce stressors as much as possible to promote higher levels of job satisfaction.

Role overload and conflict in the workplace were established as moderate sources of stress

for nursing home employees. Decreasing role pressures placed on individuals either through

additional staffing or through equal sharing of responsibilities may decrease overload.

Conflict can be reduced by training unit managers in conflict mediation skills as well as

establishing effective and trusting communication routes to promote understanding and

support (Gilton, Hall, Wodchis & Petroz, 2007). When considering the results from the job

satisfaction facets, it is suggested that healthcare organisations can increase job satisfaction in

42

their employees by openly evaluating ways to increase satisfaction with regard to pay and

fringe benefits, as well as promotion, contingent rewards and operating conditions.

Conclusion

This study provides evidence that together, belongingness, engagement and perceived

stress predict changes in experienced job satisfaction. More specifically, the increase in

subjective feelings of belonging and the decrease in perceived occupational stress predict

increases in experienced job satisfaction. Healthcare and support workers report similar levels

of belongingness, stress, engagement and job satisfaction, indicating that in the context of

nursing home work, staff experiences their workplace environment similarly no matter what

position they hold. This study encourages healthcare organisations to consider strategies to

reduce stress and increase a sense of belonging in the workplace, while also considering ways

to openly address sources of dissatisfaction. Future research will benefit from identifying the

stressors of both healthcare and support staff, adding to existing literature regarding the

intrapersonal variables that may play a part in self evaluative job satisfaction and lastly, to

link these findings to work related outcomes such as absenteeism, burnout and turnover.

43

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Appendices

Appendix A – Letter to Participant

Dear Participant,

My name is Megan Josling. I am a final year BA (Hons) Psychology student in Dublin

Business School. This research study is part of my required coursework to complete my degree. The

findings of this study will be presented to my college examination board to base my module grade on.

Also, as part of our coursework evaluation the findings will be presented at a college based poster

symposium. A copy of my thesis will be provided to the TLC Healthcare group.

The main purpose of this study is to determine if a relationship exists between belongingness,

work engagement, job satisfaction and perceived stress. Other questions I will explore include gender

and job type differences among these variables and the importance of these variables in driving

workplace related behaviour.

In this study you will be asked to complete five short questionnaires. Your responses to these

questionnaires will not be released to anyone and will be kept completely anonymous. Your name will

not be written on any of the questionnaires and all data obtained will be stored on a password

protected computer. When the data is analysed it will be done across the whole sample i.e. no

individual’s data will be analysed separately from the groups’. When the results are reported no

information that could be used to infer your identity will be reported. This study abides by the PSI

ethical code.

Your participation is voluntary, thus at any time you have the right to withdraw from

this study as well as having the right to skip any questions in the questionnaires which you do

not feel like answering. Your refusal to participate in this study will not result in any penalty or

loss of benefits to which you are entitled to. However, after you have completed and submitted

the questionnaire you should understand that you are consenting to participate in the s tudy.

Once the questionnaires are bundled it would be unethical to allow any participant access to the

questionnaires and to see other participants’ data in order to find their own.

Please take your time to answer the questions. There are no right or wrong responses. Your

participation in this study is greatly appreciated. If you have any questions please do not hesitate to

ask them. If you have any further queries my email is xxxxx@mydbs.ie. My supervisor, Dr. John

Hyland can be contacted at xxxxx@dbs.ie

Thank you for choosing to take part in my research study.

Megan Josling

53

Appendix B – Demographic Questionnaire

Demographic Questionnaire Please choose appropriate answer

1. Gender: Male Female

2. Age: ________

3. Job Type: (Please tick appropriate)

Nursing Includes : Nurses, Carers, Nursing Managers of all levels etc.

Non - Nursing Includes : Household, Catering, Administrative etc.

4. Length Of Service: _____ years _____ months

54

Appendix C – Occupational Stress Index adapted version of Srivastava & Singh’s (1981) OSI

by Singh & Dubey (2011).

Instructions

This questionnaire is meant for psychological investigation. The questionnaire consists of a

number of statements employees sometimes say or feel about various components of their

jobs. You are required to use the following five point scale to indicate the extent to which you

agree with teach statement to describe your own job and the experiences or feelings about

your job.

1 2 3 4 5

strongly disagree disagree somewhat neither agree agree somewhat strongly agree

nor disagree

Please answer all the questions

1. I have to do a lot of work in this job _____

2. The available information relating to my job

role and its outcomes are vague and insufficient. _____

3. My different managers often give contradictory

instructions regarding my work _____

4. Owing to excessive workload, I have to manage

with insufficient number of employees or resources. _____

5. The objectives of my work role are quite clear

and adequately planned. _____

6. Officials do not interfere with my jurisdiction and

working method. _____

7. I have to dispose of my work hurriedly owing to

excessive workload. _____

8. I am unable to perform my duties smoothly owing to uncertainty

and ambiguity of the scope of my jurisdiction and authority. _____

55

1 2 3 4 5

strongly disagree disagree somewhat neither agree agree somewhat strongly agree

nor disagree

9. I am not provided with clear instruction and sufficient

facilities regarding new assignments entrusted to me. _____

10. Being busy with official work, I am not able to devote

sufficient time to my domestic and personal problems. _____

11. It is not clear what type of work and behaviour my

higher authorities and colleagues expect of me. _____

12. Employees attach due importance to the official

instructions and formal working procedures. _____

13. I have to do such work that ought to be done by others. _____

14. It becomes difficult to implement all of a sudden new

dealing procedures and policies in place of those already in practice. _____

15. I am unable to carry out my assignments to my satisfaction

on account of excessive load of work and lack of time. _____

56

Appendix D - Utrecht Work Engagement Survey (UWES) by Schaufeli & Bakker (2003)

The following 17 statements are about how you feel at work. Please read each statement carefully and

decide if you ever feel this way about your job. If you never had this feeling, write ‘0’ in the space

after the statement. If you have had this feeling, indicate how often you feel it by choosing the number

(from 1 to 6) that best describes how frequently you feel that way.

Never Almost Rarely Sometimes Often Very often Always

Never

0 1 2 3 4 5 6 Never A few times Once a month A few times Once a week A few times Everyday

a year of less or less a month a week

1. At my work, I feel bursting with energy. ____

2. I find the work that I do full of meaning and purpose. ____

3. Time flies when I’m working. ____

4. At my job, I feel strong and vigourous. ____

5. I am enthusiastic about my job. ____

6. When I am working, I forget everything else around me. ____

7. My job inspires me. ____

8. When I get up in the morning, I feel like going to work. ____

9. I feel happy when I am working intensely. ____

10. I am proud of the work that I do. ____

11. I am immersed in my work. ____

12. I can continue working for very long periods of time. ____

13. To me, my job is challenging. ____

14. I get carried away when I'm working. ____

15. At my job, I'm very resilient, mentally. ____

16. It is difficult to detach myself from my job ____

17. At my work I always persevere, even when things do not go well ____

57

Appendix E - Psychological Sense of Organisational Membership, Cockshaw & Sochet’s

(2010) adaptation of Psychological Sense of School Membership by

Goodenow (1993).

Circle the answer for each statement that is most true for you.

Not at all

true

1

2

3

4

Completely

True

5

1 I feel like a real part of this organisation. 1 2 3 4 5

2 People here notice when I am good at

something.

1 2 3 4 5

3 It’s hard for people like me to be

accepted here.

1 2 3 4 5

4 Other people in this organisation take my

opinions seriously.

1 2 3 4 5

5 Most managers/supervisors in this

organisation are interested in me.

1 2 3 4 5

6 Sometimes I don’t feel as if I belong

here.

1 2 3 4 5

7 There’s at least one supervisor/ manager

in this organisation that I can talk to if I

have a problem.

1 2 3 4 5

8 People in this organisation are friendly to

me.

1 2 3 4 5

9 Managers/supervisors here are not

interested in people like me.

1 2 3 4 5

10 I am included in lots of activities at this

organisation.

1 2 3 4 5

11 I am treated with as much respect as

other employees.

1 2 3 4 5

12 I feel very different from most other

employees here.

1 2 3 4 5

13 I can really be myself in this

organisation.

1 2 3 4 5

14 The managers/supervisors here respect

me.

1 2 3 4 5

15 People here know I can do good work. 1 2 3 4 5

16 I wish I were in a different organisation. 1 2 3 4 5

17 I feel proud to belong to this

organisation.

1 2 3 4 5

18 Other employees here like me the way I

am.

1 2 3 4 5

58

Appendix F - Job Satisfaction Survey, Spector (1994).

Copyright Paul E. Spector 1994, All rights reserved.

PLEASE CIRCLE THE ONE NUMBER FOR EACH QUESTION THAT COMES CLOSEST TO REFLECTING YOUR OPINION

ABOUT IT.

Dis

agre

e ver

y m

uch

Dis

agre

e m

oder

atel

y

Dis

agre

e sl

ightly

Agre

e sl

ightly

Agre

e m

oder

atel

y

Agre

e ver

y m

uch

1 I feel I am being paid a fair amount for the work I do. 1 2 3 4 5 6

2 There is really too little chance for promotion on my job. 1 2 3 4 5 6

3 My supervisor is quite competent in doing his/her job. 1 2 3 4 5 6

4 I am not satisfied with the benefits I receive. 1 2 3 4 5 6

5 When I do a good job, I receive the recognition for it that I should receive. 1 2 3 4 5 6

6 Many of our rules and procedures make doing a good job difficult. 1 2 3 4 5 6

7 I like the people I work with. 1 2 3 4 5 6

8 I sometimes feel my job is meaningless. 1 2 3 4 5 6

9 Communications seem good within this organization. 1 2 3 4 5 6

10 Raises are too few and far between. 1 2 3 4 5 6

11 Those who do well on the job stand a fair chance of being promoted. 1 2 3 4 5 6

12 My supervisor is unfair to me. 1 2 3 4 5 6

13 The benefits we receive are as good as most other organizations offer. 1 2 3 4 5 6

14 I do not feel that the work I do is appreciated. 1 2 3 4 5 6

15 My efforts to do a good job are seldom blocked by red tape. 1 2 3 4 5 6

16 I find I have to work harder at my job because of the incompetence of

people I work with.

1 2 3 4 5 6

17 I like doing the things I do at work. 1 2 3 4 5 6

18 The goals of this organization are not clear to me. 1 2 3 4 5 6

59

PLEASE CIRCLE THE ONE NUMBER FOR EACH QUESTION THAT COMES CLOSEST TO REFLECTING

YOUR OPINION

ABOUT IT.

Dis

agre

e ver

y m

uch

Dis

agre

e m

oder

atel

y

Dis

agre

e sl

ightly

Agre

e sl

ightly

Agre

e m

oder

atel

y

Agre

e ver

y m

uch

19 I feel unappreciated by the organization when I think about what they pay me.

1 2 3 4 5 6

20 People get ahead as fast here as they do in other places. 1 2 3 4 5 6

21 My supervisor shows too little interest in the feelings of subordinates. 1 2 3 4 5 6

22 The benefit package we have is equitable. 1 2 3 4 5 6

23 There are few rewards for those who work here. 1 2 3 4 5 6

24 I have too much to do at work. 1 2 3 4 5 6

25 I enjoy my coworkers. 1 2 3 4 5 6

26 I often feel that I do not know what is going on with the organization. 1 2 3 4 5 6

27 I feel a sense of pride in doing my job. 1 2 3 4 5 6

28 I feel satisfied with my chances for salary increases. 1 2 3 4 5 6

29 There are benefits we do not have which we should have. 1 2 3 4 5 6

30 I like my supervisor. 1 2 3 4 5 6

31 I have too much paperwork. 1 2 3 4 5 6

32 I don't feel my efforts are rewarded the way they should be. 1 2 3 4 5 6

33 I am satisfied with my chances for promotion. 1 2 3 4 5 6

34 There is too much bickering and fighting at work. 1 2 3 4 5 6

35 My job is enjoyable. 1 2 3 4 5 6

36 Work assignments are not fully explained. 1 2 3 4 5 6

60

Appendix G – Debrief Sheet

The title of this thesis is:

“Belongingness, Work Engagement, Stress and Job Satisfaction in a Healthcare Setting”

The main purpose of this study is to determine if belongingness, work engagement and

occupational stress predict job satisfaction. Previous research has shown that these variables are

related to job satisfaction, but no unitary study has combined them into one research question. Other

aims include: investigating whether there is an interaction effect between belongingness and gender

on job satisfaction; whether there is a difference of perceived belongingness, engagement, stress and

job satisfaction between nursing and non-nursing staff; and lastly whether there is a relationship

between length of service and level of job satisfaction.

The study required participants to fill in one demographic questionnaire as well as four

psychological measures including:

Occupational Stress Index

Stress is the physiological and psychological reaction to relatively excess demands made on a person

(Sighn & Dubey, 2010).

Utrecht Work Engagement Survey

Work engagement according to Moura, Orgambidez-Ramos & Goncalves (2014) pertains to

workplace motivation and includes characteristics such as vigour, dedication and absorption which

help employees deal with workplace stress.

Psychological Sense of Organisational Membership Scale

Workplace belongingness is the extent to which a person feels included, supported and at one with

their psychosocial workplace environment (Cockshaw & Shochet,2010).

Job Satisfaction Survey – Cohen (1996)

Job satisfaction has been defined as the multitude of attitudes a person may hold with regard to their

employment (Ajayi & Abimbola, 2013).

These measures were given in the questionnaire set in the same order as depicted above.

Singh & Dubey (2011) suggest workplace satisfaction has major implications with regards to

staff turnover, absenteeism and productive performance. Thus it is important to identify which factors

are related to job satisfaction and apply these findings in such a way to reach optimal levels of job

satisfaction in the workplace.

If you have any other questions please do not hesitate to email me at xxxx@mydbs.ie. Again, the help

line for The Samaritans is: (01) 116 123

Thank you for taking the time to participate in this study. Megan Josling.